Tim, congrats on all your hard work coming to fruition. I am sure your life experiences will make you a better physician all the way around.
We really don’t disagree, but just look at things differently. I will stick by my original innuendo, that my doctor is clueless, especially when he looks at my 5.5 number, and says “you are making plenty of insulin” when the fact is, I am not because its only my lack of carb intake that gives me that number.
Thanks for the links, and maybe you could add your thoughts to the question I would have about what I read. I understand what some of the thinking was, but if I walked into my drs office, and he said my A1c was 7.0 and I was a diabetic, so I needed to change my lifestyle with diet and exercise, would I, or anyone else, have any success if I couldn’t test what foods were doing to me? I read the articles, and simply cannot process this kind of statement “T2’s should only need to test once a day”
As Spock would say, illogical. That is akin to taking your blood pressure once a day, and figuring its always going to be the same. If I tested an hour after a big meal, I might freak out. If I tested three or four hours after I last ate, I might think I have this thing under control, whereas neither of these scenarios are correct or proper.
I am glad to have read your perspective and to understand your position, no issues betwixt us, but if I don’t test now, when the disease appears to be fairly “minor” (if that is a good word for my numbers) then I will destroy my ability to make insulin, but constantly eating the wrong thing out of ignorance, or just plain stupidity. Then, I am going on insulin, and testing many more times a day.
I guess I have made my position clear that an ounce of prevention is worth ten pounds of cure. In America, healthcare is post-damage control, when it should be all out attempts to avoid the illnesses in the first place. Not testing people over the course of their life, for diabetes, is a crime. Given the simplicity of an A1c test that, so much so that you can do it at home, the doctors should be testing in their office. Why I have to go down to the lab, wait twenty more minutes, and give a vial of blood, and then pay the lab fees and another doctor visit fee to get the results, when his nurse could do it in the exam room in a matter of minutes, completely eludes me.
I had a stroke several years ago, and being uninsured, Iearned quickly how much things cost. You name it, I got it, from MRI to a heart stress test. The stress test is the treadmill before and after a heart ultrasound. It cost me $1200.
Doctors are happy to look up your prostate, but why do we not get a stress test for our cardio systems once or twice as we age? The sheer increase in the numbers would drive the cost down to very affordable, it gives a lot of information about our hearts and the cardio condition, but instead, we get pills to “clear out our arteries” and then get in line for a triple bypass, or worse, the cost of which way far exceeds the cost of a stress test. Treating the symptoms is something American healthcare does well. Taking care of the diseases, is something American healthcare seems to have little inclination to bother with.
Even dental insurers have figured out that unreal amounts of money can be saved if they offer free, or very inexpensive cleaning and x-rays once or twice a year. They know that its cheaper to do that, than replace your teeth one at a time over your lifetime. I wish medical doctors were as proactive.
I will grant you that many patients simply won’t, and that is their choice. What grinds on me is doctors who seem more willing to wait till my A1c climbs back into the high 6’s and even 7’s, and then they will be happy to give me all the strips I want.
I see the paradox. Many won’t test anyway, many will obsess but I also see that as a poor excuse not to allow those who see the advantage, to use the tools at our disposal. In many cases, it may not work. People who want to work at it, and control it, and knock it down good and hard, should be allowed to do just that.
In my case, I am betting the farm that my A1c number comes in at the low 6’s next time, with me testing once or twice a day at the most, and that is a shame.
However, I enjoy being able to discuss it. These forums are about the only place to have a rational disagreement or discussion.
I get the same thing with my participation in the VW Vanagon forums. Just no one in my circle of friends and acquaintances who even know what a Vanagon is, so thank goodness for forums where other drives hang out and talk!